Heart Burn and Intestinal Gas
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| What is heart burn? | substernal burning sensation that moves up toward the neck or throat
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| What is dyspepsia? | consistant or recurrent discomfort located primarily in upper abdomen. epigastric pain, burning, postprandial fullness, nausea, bloating
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| What is GERD | reflux of gastric contents into the esophagus, causing troublesome(more than once a week) symptoms or esophageal damage that interferes with quality of life
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| What is PUD? | gastric or duodenal ulcer caused by an infection or NSAIDS
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| What are some symptoms of GERD | heartburn plus acid regurgitation(acid taste in the mouth), hypersalvation, maybe dyspepsia
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| What is dysphagia? | difficult swallowing
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| what is odynophagia | painful swallowing
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| Non pharm treatment for HB and dyspepsia (8 things) | keep a symptom diary, avoid foods with lower LES pressure, Elevate head of bed by 6in or form a gerd wedge pillow, avoid laying down after meals, lose weight, smaller portions, eat smaller meals, limit NSAID use
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| Pharm treatment for HB and dyspepsia (4 kinds) | antacids, bismuth salycilate, H2RA, PPI
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| Antacids: whats the max dose/day | 600mEq/day
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| Antacids: how long can you take them? | 2 weeks max
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| Antacids: onset/duration | O:max of 5minutes. D: 20-30minutes
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| Antacids: which are preferred? | al-hydroxide and Ca-carbonate
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| Sodium bicarbonare: whats the brand name | alka seltzer
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| What does sodium bicarbonate provide relief for? | short term relief for overeating and indigestion
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| in which patients should you avoid this drug? | CHF, CRF, cirrhosis, edema, sodium restricted diets
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| Calcium based antacids: what is the brand name for this drug? | Rolaids, TUMS
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| Calcium based antacids: what are some adverse effects? | hypercalcemia, milk-alkali syndrome, constipation, benign acid rebound after meals
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| Calcium based antacids: are these safer in renal patients? | yes but in smaller doses, still be cautious in CRF patients
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| Calcium based antacids: is this ok in pregnant patients, elderly as a calcium supplement? | yes!
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| Aluminum based antacids: what is the brand name for this drug? | mylanta maximum strength, maalox
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| Aluminum based antacids: who should caution using this product? | CRF
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| Aluminum based antacids: What are some side effects? | consipation, hyperphosphateemia and intestinal obstruction
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| Magnesium based antacids: what are hte brand names for this drug? | mylanta ultimate strength, milk of magnesia
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| Magnesium based antacids: who should caution using this product | CRF
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| Magnesium based antacids: what are some side effects | diarrhea, cardiac arrythmias, respiratory depression, hypotension, NV, muscle paralysis
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| Magnesium based antacids: how can you decrease side effects of this drug? | use in combination with aluminum products
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| Alginic acid: what is the brand name of this drug | gaviscon
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| Alginic acid: whats the MOA | forms a barrier that floats on top of the liquids in the stomach
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| Alginic acid: when can this be used? | GERD not PUD
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| Bismuth Subsalycilate: what is the brand name for this drug | kaopectate, peptobismol
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| Bismuth Subsalycilate: when should you use this | HB, upset stomach, indegestion, nausea and diarhhea
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| Bismuth Subsalycilate: what are some side effects? | darkened stool and tongue
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| Bismuth Subsalycilate: dosing | 2 chewable tabs or 2 TBS after meals for no more than 14 days
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| H2RA: what are hte brand names for this drug | pepcid, zantac, tagamet, axid AR
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| H2RA: When should this be used? | treatment of mild to moderate, infrequent, episodic HB and for the prevention of HB associated with acid indegestion
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| H2RA: onset and duration | O: 30-45 min D: 4-10 hours
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| H2RA: how early should i take this? | 30 mins prior to event
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| H2RA: how many times a day can i take this | max of 2x/day and a max of 2 weeks
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| H2RA: side effects | HA, N.V, C/D ratidine: dark tongue and stool, cimetidine: hair loss
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| H2RA: drug interactions | cimetidine interacts with warfarin, theophyline, phenytoin
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| PPI: duration and onset | D: 12-24 hrs O:2-3 hours
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| PPI: when can i repeat treatment? | 4 months
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| PPI: at what age can i take these? | 18
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| PPI: side effects | diarrhea, constipation, abdominal pain, headache,
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| PPI: drug interactions | warfarin, cyclosporine, benzodiazapenes, phenytoin, methotrexate
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| PPI: geriatrics | usually refer, more likely to have SE, stay away from Na-bicarbonate, H2RA and PPI are preferred
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| PPI: pediatrics | H2Ra are not recommended, avoid bismuth subsalycilate, dont use PPI, refer if under 12`
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| PPI: pregnancy | treat with lifestyle change, use antacids but not Na-bicarb, refer before using a H2RA, dont use PPI
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| PPI: lactation | Mg and Al hydroxide are notsecreted into the milk, can be used, rantidine and famotidine are also ok, dont recommend PPI
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| exclusions for self treatment | HB for over 3mo, Hb that continues for 2 weeks, pregnancy, children under 2
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| Int Gas: what can cause gas | food, medical conditions, drugs, actions
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| Int Gas: symptoms | belching, abdominal discomfort, bloating, nausea, bowel sounds, dyspepsia
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| Int Gas: non pharm | reduce gas causing triggers, increase exercise, avoid tight clothes
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| Int Gas: pharm treatment - simethicone: can it be given to children | yes, and infants
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| Int Gas: pharm treatment - simethicone: when is it used? | when you have gas or arent sure what causing the gas
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| Int Gas: pharm treatment - activated charcoal: whats it recommended for | odorous gas
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| Int Gas: pharm treatment - activated charcoal: can it be used in combo? | yes, add to simethicone and thats a ok
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| Int Gas: pharm treatment - activated charcoal: should you recommend? | nope lol
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| Int Gas: pharm treatment - alpha galactosidase: what is it used for?` | helps with foods that contain oligosaccharides
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| Int Gas: pharm treatment - alpha galactosidase: are their special populations to watch out for | caution in diabetics
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| Int Gas: pharm treatment - lactase replacement products: when can this be used | people who are lactose intolerant
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| Int Gas: pharm treatment - probiotics: what is it used for | GI complaints including intestinal gas and bloating
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| Int Gas: pharm treatment - probiotics: how long should it be used? | 14 days trial period
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| Int Gas: pharm treatment - probiotics: who should this not be recommended to? | people with pancreitis
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| Int Gas: exclusions for self treatment | gas that persists for several months, severe symptoms, sudden change in lactation and abdominal pain, onset of symptoms in patients over 40, sudden change in bowel symptoms
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| Int Gas: what is Alpha galactosidase used for | as a preventative measure to gas
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| Int Gas: what do you give if someone wants immediate relief from gas but cant associate gas with a particular food? | simethicone
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